MORE than 150 years ago the Welsh mining community of Brynmawr became the first in the UK to establish its own board of health.

Almost a century later Wales was the birthplace for the National Health Service as Ebbw Vale MP Aneurin Bevan realised his vision of a state that could care for its citizens from the cradle to the grave.

Our scientists are among some of the foremost experts in the world, investigating diseases and testing cures that could hold hope for modern mankind - much of the work on the groundbreaking cancer drug Tamoxifen which has revolutionised the treatment of breast cancer, was completed in Wales.

The country has a long and proud association with health in the UK - remember the spa towns of the 19th Century which were a popular magnet for Victorian visitors seeking a cure and respite from their aches and pains? Those days are now but a distant memory.

Today Wales has earned itself the dubious title of the sick man of Europe - the health service that Bevan was so proud of is now struggling to cope under the sheer weight of the nation's ill health.

Wales comes perilously close to topping the league tables for disease and stands with its head held shamefully low in its attempts to treat those diseases.

It may be a beautiful place to live, with fantastic natural vistas and breathtaking scenery, but sadly for the majority living in Wales that beauty is marred by the ever-present shadow of ill health.

What better quality of life we enjoy in other areas is almost wiped out by the burden of illness.

There is a brief chapter at the end of the latest tome of Welsh statistics that compares the nation to the rest of the UK. If the figures make gloomy reading then the summary is positively depressing.

We may have the lowest stillbirth rate and the lowest infant mortality rates but our crude death rates are the highest in the UK.

We have the highest cancer death rates - and the lowest proportion of women who are regularly screened for cervical cancer and breast cancer.

We have the highest number of prescriptions dispensed per patient and some of the largest GP list sizes.

And despite weekly reports detailing new initiatives to improve our heart health more men and women continue to die from circulatory and respiratory diseases every year than across Offa's Dyke.

But why should Wales, which after all is not that different from England in terms of our demographic make-up - although we have a higher proportion of older people - have such poor health?

Professor Kevin Morgan, of Cardiff University, believes the nation's poor health is the result of a 'noxious cocktail' of poverty, lifestyle and diet.

Others have attributed the higher rates of disease to the legacy of our industrial heritage. Health Minister Jane Hutt has spoken numerous times of a "legacy of ill health."

The links between poverty, deprivation

and ill health are well documented and there is powerful evidence to support Richard Wilkinson's assertion that it is not the richest societies that enjoy the best health, but those that have the smallest income differences between rich and poor.

"Inequality and relative poverty have absolute effects: they increase death rates," the senior research fellow at the University of Sussex has said.

It is no coincidence that the local authority areas of Merthyr Tydfil and Blaenau Gwent top both the unemployment and deprivation scales and have

some of the poorest life expectancy rates in the UK.

Sickness levels are high - one in four unemployed people are claiming sickness benefit and as many as one in three consider they have a limiting long-term illness.

But deprivation alone cannot account for why our health is that much worse than in England - the former South Wales coalfields make up a significant chunk of Wales in population terms yet their relative poverty does not explain why some cancer rates are higher in North Wales.

And, if deprivation is such a driving factor, why are secondary school children in the Valleys as overweight and share the same worrying rates of obesity as those children living in more privileged areas of rural west Wales?

Perhaps the most persuasive argument for our poor health is our lifestyle and our inability to take ownership for our own health in Wales. Many GPs have complained of fire-fighting - concentrating on the acute problem rather than educating people about preventative measures - in the face of unacceptable shortages and waiting time within the NHS in Wales, but many have also complained that we are not listening or acting on the hundreds of health promotion initiatives launched every year.

Are we, as a nation, too fond of our cigarettes and pints and not yet ready to say no to a plate of fried chips and a pie packed with processed meats? Do old habits die hard?

It may just be that our inability to compromise our high-fat sedentary lifestyles is as much to blame for our poor quality of health as Wales's socioeconomic make-up and our poor access to healthcare.